There is a wealth of research on the extent to which bone loss may impair strength and increase the risk of fracture. The rate of mortality after hip fracture in elderly patients with osteoporosis is reported to be as high as 30%. It is suggested that augmentation of the femur is an effective countermeasure to reduce the risk of fracture in highly osteoporotic hips. This technique would be especially valuable for those patients at high risk of falls and the highest risk of mortality and morbidity if they were to sustain a fall. The few clinical case studies that have been performed on augmentation of the femur, suggest that a successful outcome requires detailed planning, biomechanical analysis, and precise control of the augmentation procedure to avoid generation of areas of high stress due to augmentation. Our long term goal is to develop a technology that enables the surgeon to precisely determine the extent of osteoporosis and fracture risk level, obtain an optimized surgical plan based on computerized mechanical analysis, perform a rapid and minimally invasive hip augmentation with intraoperative biomechanical feedback, and finally verify the outcome in one patient visit. In this project, we will develop a surgical testbed for proximal femur augmentation and demonstrate its feasibility. Towards this goal, we propose three aims: 1. Develop a geometrical and biomechanical planning module for patient-specific optimization of the bone augmentation procedures using preoperative CT scans. 2. Develop an integrated surgical execution system that will involve co-registration of the preoperative model and surgical tools with a fluoroscope and an optical navigation system specifically developed for this project. 3. Validate functional performance and overall system accuracy. The technology developed in this project may lead to a highly needed alternative treatment that may be pivotal for patients at the risk of bone fracture due to osteoporosis. The technology developed in this project, will provide a highly needed alternative treatment for patients highly susceptible to bone fracture due to osteoporosis. [unreadable] [unreadable] [unreadable]